A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Wednesday, February 27, 2008

Yo, Pharmacists!

I have a favor to ask all you pharmacists out there: How about getting together and adopting a universal fax form for requesting refills on patient medications?

As things are now, each store or chain has a different form that has all the same things on it, but in different places. They all have the store name, phone and fax numbers; the same information about the patient and the meds; and the same confidentiality statement. Would it really be so difficult for you to standardize your form? (Also, now that the chains are gobbling up more and more stores, it should actually be possible to implement something like this.)

Once upon a time, all the insurance companies had their own individual claim forms. Even though they all wanted the same information, they each insisted on their own form. It was enough of a PITA so that eventually a universal claim form was developed. It didn't improve payment all that much, but it definitely made things easier in the billing office.

I know it's not earth-shattering, but having a pile of six refill faxes from six different pharmacies, some portrait and some landscape, with all the key info in completely different places, is tiring and inefficient. Is it really asking all that much to get your act together and cooperate, for the sake of our patients as well as us docs?

Fortunately I don't have to deal with this very much in the ED. Why can't you just create your own form with all the information on it and use your single form to fax refill information to all of the pharmacies?

Whitecoat: the issue is READING the different forms and trying to figure out the who/what/where they want. Not a big deal in and of itself, but a cumulative pain; one that seems to offer such an easy fix. Just takes a little cooperation. (Ha!)

When I was working in Vancouver I made my own form and sent it to the pharmacies.....typed, neat, legible. A couple of pharmacies initially asked me to 'use their form', but when I asked them to just send my patients on to pharmacy X which liked my forms just fine they decided my forms were okay after all.Here in the eastern arctic there are only 2 pharmacies....the pharmacists know my writing so well I could probably write an Rx on a playing card and get it filled....Dr. J.

Standardizing phone messages for phoned-in prescriptions would help, too (calling in an RX to Pharmacy A: "press 1 if this is a physician's office", Pharmacy B: "if this is a doctor's office, press 8", Pharmacy C: "press 1 for pharmacy"; after pressing 1 for pharmacy, wading through another tier of choices: "if this is a doctor's office, press 1 to leave a message, 2 to speak to a pharmacist. If you are a patient refilling a prescription, press 3". I can't tell you how many times I've pressed the wrong button and had to hang up and start again (perhaps just a "start from the beginning" prompt is needed!)A

There are also websites you can use for eprescibing. Doesn't require software and its never been down in the 6 months or so our office has been using it. However, while some of the pharmacies have started to send their requests online, most still send the barage of faxes each morning, which doesn't help the problem you describe.

I can sympathize though; I spent five minutes trying to find a patient's date of birth on a refill request yesterday. What a waste of time.

Dino, I know it must be frustrating, but as pharmacists, we have virtually no control over the format of the faxes that are sent. Most are internal faxes that are sent over and, unfortunately, each chain has their own standard format. My biggest beef with some physicians offices is that they don't read the message. For instance, if we fax over a prior authorization request with a phone number to call, we on occasion, get the obligatory (ok to refill x 2). Huh? Perhaps, somebody didn't read the fax. From reading your posts, you're still not sold on the technology of EMR. There is a website www.nationalerx.com that allows physicians to e prescribe for free. I'm not sure how user friendly it is, but may be worth a look. The biggest pitfall I see right now with e-prescribing is with controlled substances. Currenlty, we can fax and receive verbal orders for controlled substances (C IIs obviously, the exception), but federal law prohibits erxing controlled substances, wether it be new or a refill. Until the laws are changed, the adoption of the technology won't take off. So for now, we'll have to deal with each other's "differences" and make things work out for the best interest of the patient.

I think that would be great, honestly. I also think it would be great if you docs got your act together and cooperated by using universal prescription pads. That would also make everyone's life easier, no? ;)